Sick in U.S. more likely to skip care than elsewhere

CHICAGO (Reuters) - Americans who have a chronic illness or serious health problems are more likely to struggle to pay their medical bills or have problems getting needed care than adults with similar problems in other high-income countries, a survey released on Wednesday found.

The poll of more than 18,000 adults in the United States and 10 other high-income countries found that Americans were most likely to have problems getting needed care because of the cost, or to medical debt, according to data released by the Commonwealth Fund.

"Despite spending far more on health care than any other country, the United States practically stands alone when it comes to people with illness or chronic conditions having difficulty affording health care and paying medical bills," Commonwealth Fund president Karen Davis said in a statement.

Previous reports by the nonprofit fund, which conducts research into healthcare performance and promotes changes in the U.S. system, have been heavily used by policymakers and politicians pressing for healthcare reform.

The 2011 telephone survey included people who said they were in fair or poor health, those who had surgery or had been hospitalized in the prior two years, or those who had been treated for a serious or chronic illness or injury in the prior year.

It found that 42 percent of the 1,200 U.S. adults with health problems in the survey went without care because of costs, and more than a quarter said they could not pay, or had serious problems paying, medical bills.

That compared with a range of 1 to 14 percent of adults in other countries polled -- Australia, Britain, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden and Switzerland.

More than a third of patients polled in the United States paid more than $1,000 in medical costs in the past year, compared with fewer than 10 percent of those polled in France, Sweden and the United Kingdom -- countries with the lowest rates.

MEDICARE COVERAGE

According to the survey, 51 percent of U.S. adults with health problems who were under age 65 went without care because of costs, compared with 19 percent of adults 65 and older, who were covered by the Medicare insurance program for the elderly.

The study also found wide gaps in access to healthcare.

More than seven out of 10 patients in Britain, Switzerland, France, New Zealand and the Netherlands were able to get same- or next-day appointments when they were sick.

By contrast, just half of patients in Sweden and Canada reported such rapid access to care.

Many patients in the study also reported gaps in coordination of their care, including doctors ordering duplicate tests and medical records or test results being unavailable during a medical appointment.

Among those surveyed, 56 percent of Germans, 53 percent of French, 43 percent of Norwegian and 42 percent of American patients reported such gaps.

By contrast, only 20 percent of patients in Britain and 23 percent of patients in Switzerland reported gaps in care.

The survey was conducted by Harris Interactive and contractors within each country.